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Itiliti Health

A better way to prior-authorize.

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Overview

Itiliti Health focuses on solving the prior authorization problem by making payer rules and medical policies transparent and accessible to providers at the point of care. Their PA Checkpoint solution helps determine if an authorization is required before one is ever submitted, reducing unnecessary administrative work.

✨ Key Features

  • Prior Authorization Requirement Check (PA Checkpoint)
  • Medical Policy Transparency
  • Automated Authorization Routing
  • CMS Interoperability Rule Compliance

🎯 Key Differentiators

  • Focus on upfront transparency of payer rules
  • 'Is an auth required?' check to prevent unnecessary submissions
  • Strong focus on helping payers meet CMS compliance mandates

Unique Value: Reduces administrative waste by making payer prior authorization rules clear and accessible upfront, eliminating unnecessary work for providers.

🎯 Use Cases (3)

Instantly determining if a prior authorization is needed for a specific service Accessing and understanding payer medical policies directly within the workflow Ensuring compliance with CMS prior authorization mandates

✅ Best For

  • Real-time check for prior authorization requirements
  • Providing transparency into payer clinical policies

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • End-to-end claims management and billing
  • Patient eligibility and benefits verification

🏆 Alternatives

Cohere Health Rhyme Payer-specific portals

Focuses on preventing the need for an authorization submission in the first place, rather than just automating the submission itself.

💻 Platforms

Web API

🔌 Integrations

EHR systems Payer systems API

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Enterprise tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ SOC 2 ✓ HIPAA

💰 Pricing

Contact for pricing
Visit Itiliti Health Website →